• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.24 no.4
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• pp.446-452
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• 2014

Objective: This study aimed to evaluate the exposure status of formaldehyde(FA) among the nurses in ambulatory care departments of university hospital. Methods: Two university hospitals were surveyed. The FA concentration in air were measured to target 62 nurses in 8 ambulatory care departments(89 samples). Air sampling and analysis of FA were carried out according to the OSHA Method ID-205. The survey was conducted with questionnaire asking about how to control FA and whether the nurses use the formaldehyde protectors or not. Results: FA was detected in all samples. The maximum concentration of FA was 0.258 ppm and the geometric mean was 0.023 ppm. There was no sample that exceeded any of exposure standards by OSHA-TWA whereas there were 54 samples(60.7%) that exceeded the standards by NOISH-TWA. Among 62 nurses handling FA, 13 nurses(21.0%) used the protective gloves while nobody used a gas mask. It was assessed that any of 8 common ambulatory care departments did not use a safety cabinet for FA in which local exhaust ventilation was fixed. Conclusions: Nurses in ambulatory care departments were exposed to FA. Therefore, the environment management of a workplace, the health management of a nurses, FA handling education and installing a FA cabinet with a local exhaust ventilation were needed because FA as a carcinogen was able to cause any cancer to a human body if it was emitted in air for long time.

• Journal of The Korea Institute of Healthcare Architecture
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• v.25 no.2
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• pp.51-62
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• 2019

Purpose: This study aims to examine spatial characteristics of ambulatory care department Chronologically through case studies; and to consider the social implication of these spatial changes. Methods: In this study, a total of eight ambulatory care departments, one or two for each period, were selected in order to analyze the spatial characteristics. Results: First, since the 1990s, the outpatient department of the US has been changed into a patient-centered space by providing high quality outpatient medical services through individual exam room planning. Second, the exam room has been changed from open/semi-open/group exam room to individual exam room since 1990, and the trend is shifting from the cluster type to the modular type consisting of universal exam rooms in order to achieve the flexibility of exam room. Third, the diagnostic/testing area has been deployed to the ambulatory clinic to enable 'one-stop shopping' for patients-centered care since 1990s, however, it has been disappearing since 2000 due to Reduce medical expenses. Fourth, the Central Nursing Station type first appeared in the outpatient department In the 2000s, followed by the type of decentralized nursing station type since 2010s. And fifth, the area of medical support has been placing to be concentrated on one place due to the Lean Design strategy since 2010. Implications: In the future, it is expected that Korea will be more focused on efficiency, visual control, and flexibility in the planning of the ambulatory care department as in the case of the United States.

• Journal of Convergence for Information Technology
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• v.10 no.10
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• pp.253-258
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• 2020

This study analyzed, the characteristics of ambulatory care sensitive conditions(ACSCs) in patients visiting emergency departments(EDs) and compared characteristics according to two age groups (adults aged 19-64 years and, elderly people aged ≥65 years). By accessing data from the National Emergency Department Information System(NEDIS) from January 1 to December 31, 2018, we examined the proportions of different ED types and ACSCs, length of stay(LOS) in the ED, LOS hospital, and hospital admission rates. Regarding the types of EDs, we found that the proportion of local emergency medical centers was high(P<0.001). Regarding the rates of different ACSCs, 31.7% of adults were treated for gastroenteritis, a high proportion of the elderly people(48.2%) were diagnosed with and treated for pneumonia(P<0.001). The LOS in the ED was longer in elderly people for all diseases categories, except for congestive heart failure and diabetes(P<0.001). The LOS in the hospital was also significantly longer in elderly people for all ACSCs(P<0.05), and the admission rate was significantly higher in elderly people for all diseases, except for diabetes(P<0.01). Thus, analyzing the ED visits made by patients with ACSCs will need to strengthen the health-care policy to induce treatment centered on outpatient.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.6
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• pp.2161-2168
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• 2010

The administration data of the national health insurance and health insurance bills were utilized in this study. The data of 485,953 patients who were at the age of 30 and up and used the out-patient departments of every medical institution located in some regions involving two southern and northern provinces once or more during a 184-day period from July to December, 2008. As a result of analyzing their Continuity of Ambulatory Care and factors affecting it, the following findings were given: The continuity of ambulatory care among the adult patients with hypertension in our country turned out to be on a high level(MMCI $0.96{\pm}0.13$, MFPC $0.96{\pm}0.12$). Given examining the outpatient medical-cure continuity level according to index, the averagely medical-cure continuity level was calculated to be high level with MMCI, $0.96{\pm}0.13$, and MFPC $0.96{\pm}0.12$. Thus, the tendency of visiting only one medical provider was high. The findings of the study illustrated that the average continuity of ambulatory care among the adult patients with hypertension in our country was on a high level, and it seemed that special care should be provided to patients with a low-level continuity of ambulatory care, such as women and elderly people aged 64 and over. The findings of the study are expected to serve as one of the barometers for the health care of patients with hypertension and for the performance of national hypertension management plans.

• Health Policy and Management
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• v.5 no.1
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• pp.31-58
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• 1995

The Korean government achieved the universal coverage of health insurance in July 1989, and concomitantly introduced a new measure of regulated health care delivery system in using medical care. There are three reasons why the government took the new health care delivery system. Firstly, there was ample room for improving the allocative efficiency in the use of medical facilities. And the second one was to constrain the dramatic increase of medical demand under health insurance. Thirdly, and the most important reason was to alleviate the patient crowdedness in big general hospitals, particularly tertiary hospitals. There are essentially two different ways to control the use of health care : one is to cut the demand for health care, and the other to regulate behaviors of providers through the use of incentives/disincentives, demand-side approach or supply-side approach. The objective of this study is to examine whether or not medical care utilization behaviors under health insurance scheme have been changed among medical facilities such as clinic, hospital, general hospital and tertiary hospital in comparison with those before and after the introduction, particularly whether the patient crowdedness in tertiary hospitals has been alleviated or not. In order to conduct this study, the insurance claim data during the period of January 1989 and July 1992 were analyzed by focusing on diagnosis of both inpatients and outpatients, and especially the fifteen most frequent diseases in ambulatory care and the seven most frequent diseases in hospitalizatio. In addition, the same analyses were made on the changes in medical care utilization by specialty department. This was because the five departments, such as family medicine, ENT, eye, dermatology and rehabilitation, were exempted from applying the regulated health care delivery system in tertiary hospitals. The study revealed that a remarkable alleviation effect in the crowdness was noted for tertiary hospitals. This effect was most conspicuous for the most frequent mild diseases of both inpatient and outpatient care. For example, the fifteen most frequent OPD care at tertiary facilities have decreased as much as by 40%, of which 34% belonged to the cut in initial visits. Meanwhile, the proportion of those who used general hospitals and private practitioner's clinics have increased due to the shift of patients. The cases from the five special departments were also decreased, but not so much as other departments. A problem was noted that, as time passed by, the decreasing tendencies of crowdness at tertiary hospitals due to the regulated system became slightly smaller. Therefore, through complementary remedies are needed for the future implementation.

• Journal of The Korea Institute of Healthcare Architecture
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• v.21 no.1
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• pp.17-26
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• 2015

Purpose : This study examined the social and environmental change in the outpatient department of psychiatry, were analyzed disease characteristics and using characteristics of the mental illness. Thus, this aims to provide a material that can be used for efficient spatial composition of psychiatry. Methods : This study was conducted through a literature review, observation surveys, interviews. Results : Psychiatry is aware of the need to respond to the current needs of ambulatory space, there are concerns that the spatial configuration for your needs. In accordance with the results of studies conducted are as follows: 1) Specialty care programs and space needs based on segmentation and specialization of the disease 2) Considered in conjunction with the layout of essential space and other departments 3) Spatial composition and furnishings for characteristic of psychiatry 4) Spatial configuration taking into account the patient's characteristic. Implications : This study looked at the change of social change and the environment related to psychiatry. Grasp the present state of spatial composition in psychiatry. And the use characteristics of patients and guardians were investigated. Meanwhile, studies of psychiatric outpatient department is still lacking. As a result, its significance is to analyze the spatial composition requirements.